Blood clots: Risk factors, prevention

By the time she was taken to hospital, a blood clot had moved to the lungs so she she had difficulty breathing. Maria Nakimuli was five months pregnant and her feet had started swelling. She had complained about leg cramps and shortened breath in the night but because her husband did not know what exactly it was. He told her to wait until the next morning to take her to hospital.
“I did not have a car to take her to hospital. I thought it was the usual pain so I gave her some pain killers which I thought would sustain her through the night. At about 5am, the pain intensified, she gasped for breath and then fainted,” Ronald Mwanje, now a widower recalls.
He then asked a neighbour to help him take the wife to hospital.
“On arrival, “the doctor said he was not going to waste my money. My wife was dead and the post mortem revealed that she had a blood clot in the lungs.”

What exactly happens?
When the body sustains an open wound, platelets within the blood form a plug to stop the bleeding as an automatic response. When this occurs at the site of a wound, it is beneficial to the body’s defense system and repair process.
However, sometimes this gel-like mass can form in our blood vessels where they should not. When blood clots form inappropriately inside an artery or vein, they may cause significant problems because blood flow past the clot is decreased. This is very harmful according to Dr Barbara Kakande, a cardiologist at UMC Victoria Hospital.
Although clots usually dissolve, they are very dangerous and can be fatal if they do not. When blood clots form inappropriately inside an artery or vein, they may cause significant problems because blood flow past the clot is decreased. Sometimes the clots that form in the blood vessels are small and stay in one place. These are not dangerous except that they may be painful.
She says, “However, if the clot moves and goes to the veins of your heart and lungs, it can obstruct blood flow and become very dangerous. Most people who die of clots die of those that have moved usually from the veins in the legs and lodge in the vessels that supply blood to the lungs.”
If the clot that has moved to the lungs is large, it can cut off blood supply to the lungs and in a few minutes, someone could die if they do not get good emergency care immiediately.
According to Dr Levi Kwarisiima, a cardiologist at Mulago hospital, this type of clot is called a pulmonary embolism. “Such lung clots that are big cause large numbers of deaths because from the onset of symptoms to death could be a few minutes unless you are in a hospital or are near one. It is, therefore, important that everyone becomes vigilant; knows the warning signs and what to do and also how to prevent it.”
Dr Kakande says it is hard for one to know that they have developed a clot because it cannot be seen or touched but there are signs to look out for.
“If you get a dull, throbbing, pulsating or cramp-like pain in your limb muscles especially the calf muscle that is one-sided, associated with some swelling, warmness and redness, this may be a sign of a clot in that area,” he says. It is such clots that dislodge and move to the lungs that eventually kill. Common places for such pains are the calf muscle. If you experiences unusual shortness of breath even for a few seconds be suspicious. This could be a

sign that smaller clots could have been forming that are already moving and causing small blockages in your lungs. Other symptoms include sudden chest pain that worsens when you breath, nausea and vomiting, sweating, feeling of anxiety and being restless, coughing and sometimes coughing of blood, fainting and coughing of blood.

Risk factors
•Sitting for long hours without getting up or frequent long journeys by road or air.
•Immobility due to hospitalisation, suffering a stroke, or some form of injury that keeps you from moving
•Recent surgery is also a risk factor
•If you have ever had any history of a clot or something called Deep Vein Thrombosis (DVT).
•Smoking significantly increases your risk
•Living in polluted areas .
•Being overweight
•If you are either pregnant or have cancer your risk for clots goes up.
•Note that people who have respiratory illnesses such as asthma may not easily detect a clot because of the similarity in shortness of breath presentation.

What to do
Inform someone close to you about it and let them know what your suspicions are and seek qualified medical help.
Dr Kakande warns against downplaying the symptoms as what you tell the doctor will determine the way they will assess the risk. Do not wait until the next day.
Go to a hospital that has the capability to do the required tests and advanced scans in case they are needed and one where you will have access to a physician and mention that you are concerned about a clot and want to have it evaluated,” he advises.

Prevention
According to Dr Paul Kasene, a nutritionist at Wellcare centre, one can reduce the risk of getting clots by losing excess weight to attain a healthy body mass index.
“Avoid a sedentary lifestyle by exercising more regularly. Exercising helps improve blood circulation. He recommends people to eat foods that enhance proper blood circulation prevent clots these may include ginger, cinnamon, garlic, turmeric, green tea, nuts and seeds.”
Eat omega 3 rich foods such as fish, seeds and nuts because they reduce the risk of blood clotting by preventing blood platelets from clumping together. Drink enough water and stay hydrated.